Percutaneous endoscopic gastrostomy in dysphagia due to cerebrovascular disease. A 10-year experience

Objective. Dysphagia is frequent in stroke patients and is a potential cause of serious complications. In many cases the use of percutaneous endoscopic gastrostomy (PEG) may became necessary. We analyzed a consecutive series of patients who underwent PEG, with the aim of evaluating the causes of dysphagia as well as the outcome. Patients. We studied 79 patients, 52 (66%) women and 27 (34%) men who underwent PEG in the period from 1996 to 2005. The stroke was hemorrhagic in 7 (9%) and ischemic in 72 (91%) patients. In 49 (62%) patients, the stroke was a first-ever episode; in 30 (38%) it was a recurrence. Results. We found a predominance of small vessel disease in comparison with large artery atherosclerosis and cardiac embolism. In the large majority (80%) of cases, chronic dysphagia was associated with bi-hemispheric lesions or direct brain stem involvement. The mean interval (\ub1SD) between stroke onset and PEG was 21.8 \ub1 14.3 days. Easily controlled local complications occurred in 20 cases. Conclusion. In our experience, PEG was shown to be an effective and reliable procedure. Bihemispheric lesions (in particular lacunae) or brain stem involvement were the most frequent causes of chronic dysphagia. \ua9 SINPE-GASAPE